US3576288A

US3576288A - Medical instrument

Info

Publication number: US3576288A
Application number: US766544A
Authority: US
Inventors: David T Green
Original assignee: United States Surgical Corp
Current assignee: United States Surgical Corp
Priority date: 1968-10-10
Filing date: 1968-10-10
Publication date: 1971-04-27
Anticipated expiration: 1988-04-27
Also published as: SE357882B; CA930272A; GB1284289A; DE1950760A1

Abstract

There is disclosed an attachment designed to be carried by a clamping tool such as an hemostat for providing said tool with the capability of sealing the end of a fluid carrying vessel such as a blood vessel by means of staples. A staple cartridge is easily secured to an hemostat; and while the hemostat temporarily clamps and seals the end of a blood vessel, staples are smoothly ejected thereby perfecting a more permanent seal and permitting the removal of the hemostat.

Description

United States Patent [72] Inventor David T. Green Norwalk, Conn. [21 Appl. No. 766,544 [22] Filed Oct. 10, 1968 [45] Patented Apr. 27, 1971 [73] Assignee United States Surgical Corporation Baltimore, Md.

[54] MEDICAL INSTRUMENT 15 Claims, 17 Drawing Figs.

[52] U.S.Cl 227/111, 227/ l 9 [51] Int. Cl 1325c 5/02 [50] Field oiSearch 227/19; 29/212 (D); 128/325, 334, 337

[56] References Cited UNITED STATES PATENTS 1,452,373 4/1923 Gomez 227/19UX 2,301,622 1 1/1942 Hambrecht 227/19UX 2,853,074 9/1958 Olson 227/19UX 2,874,384 2/ I 959 Krone 227/19UX 3,082,426 3/1963 Miles 29/212 3,269,631 8/1966 Takaro 227/ 19X Primary Examiner-Granville Y. Custer, Jr. An0meyFleit, Gipple & Jacobson permanent seal and permitting the removal of the hemostat.

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PATENTED APRZ 7197! 3.576288- SHEET u 0P4 1 b INVENTOR' DAVID T. GREEN UZZ/ 4W, 2% M ATTORNEYS MEDICAL INSTRUMENT BACKGROUND OF THE INVENTION Whenever the severance of a blood vessel is made necessary in the course of a surgical operation, it is also necessary to seal the open ends of the vessel in order that the patient does not lose an excessive amount of blood. It is therefore general practice to use hemostats to seal open blood vessels either for the entire duration of the surgical procedure or until the vessels can be more permanently sealed by means of surgical thread manually positioned by the surgeon.

If it is the practice to employ the hemostat clamp for the duration of the operative procedure, it is readily seen that the surgical field can become quite cluttered if it is necessary to clamp a large number of vessels. If on the other hand, it is the practice to have the surgeon tie each vessel with a suitable thread, it becomes obvious that the duration of the surgical procedure can be greatly increased as well as the complexity of such a procedure.

SUMMARY OF THE INVENTION The present invention relates to a staple cartridge which is designed to be carried by a clamping tool. The ultimate goal of the invention is to provide the clamping tool with the added capability of stapling closed the object being clamped. More particularly, the staple cartridge of the instant invention is designed for rapid attachment to an hemostat so that while said hemostat is holding closed the severed end of a blood vessel, a staple can be smoothly inserted into said vessel to perfect a more permanent seal. After the staplingaction, the hemostat can be removed without breaking the seal.

It should be obvious from the above that an attachment such as that contemplated in the present invention greatly adds to the efficiency of most surgical procedures. The time required for the placement of a staple, according to the teachings of the present invention, is far less than that required for a surgeon to manually tie a blood vessel. As a result, fewer hands and fewer hemostats are required in the operative arena and the duration of a given operation is lessened to a considerable degree. Such factors are of great import when a human life is at stake.

Accordingly, it is an object of the invention to provide an attachment for a clamping device which gives to such device the capability of sealing the end of the object being clamped.

'It is another object of the invention to provide a staple cartridge which attaches to a hemostat making possible the simultaneous clamping and stapling of a blood vessel.

It is a further object of the invention to provide a simple and inexpensive staple cartridge in order that said cartridge can be attached to a clamping tool, employed until its staples are exhausted and then discarded.

I It is still another object of the invention to provide a stapling .attachment for a surgical tool which can be packaged in a sterile container, attached to said tool and used without the necessity for preoperative sterilization.

It is yet a further object of the invention to provide a staple cartridge for use with an hemostat which can be easily and rapidly attached to said hemostat thereby allowing the efiicient replacement of an exhausted cartridge during a surgical operation.

These and other objects of the invention, as well as many of the attendant advantages thereof, will become more readily apparent when reference is made to the following description taken in conjunction with the accompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS In FIG. I there is shown a top plan view of the bracket of the present invention when attached to an hemostat;

FIG. 2 is a side elevation taken along line 2-2 of FIG. 1; FIG. 3 is a cross-sectional view taken along line 3-3 of FIG. I;

FIG. 4 is a cross-sectional view taken along line 4-4 of FIG.

FIG. 5 is a side elevational view taken along line 5-5 of FIG.

FIG. 6 is an exploded side elevational view of the staple magazine of the present invention;

FIG. 7(a) is a top plan view of the staple hammer shown in FIG. 6;

FIG. 7(b) is a top plan view of the staple housing shown in FIG. 6;

FIG. 8 is an enlarged top plan view of the staple hammer shown in FIG. 7(a);

FIG. 9 is an enlarged top plan view of the staple housing shown in FIG. 7(b);

FIG. 10 is a side elevation of the staple cartridge attached to an hemostat before a stapling stroke;

FIG. II is a view similar to that shown in FIG. 10 but during a stapling stroke;

FIG. 12 is a plan view of the cylindrical cam showing the functions of the parts of the cam groove;

FIG. I3 is an enlarged vertical cross-sectional view of an assembled staple magazine;

FIG. I4 is a cross-sectional view of the staple magazine taken along line 14-14 of FIG. 13;

FIG. I5 is an enlarged end elevation of an assembled staple magazine including the staple hammer;

FIG. I6 is an enlarged end view of the staple cartridge at the completion of a stapling stroke; and

FIG. I7 is an enlarged side elevation, partially in section, of the cartridge shown in FIG. 16.

DETAILED DESCRIPTION OF THE DRAWINGS Referring first to FIGS. 1 through 5, there follows a description of the bracket which forms a part of the present invention. The bracket is shown generally at 10 and is attached to a hemostat 12 having a pair of

handle portions

14 and 16, respectively and a set of jaws, or gripping members, shown generally at 18. The handle portions and the jaws rotate, in a well-known manner, about a pivotal pin 20.

The bracket 10 is securely affixed to the hemostat 12 by the coaction of three flange portions. The first flange portion is shown at 22 and engages one of the handle portions 16 of the hemostat I2. The second flange portion, best shown in FIG. 3, comprises a first restraining wall 24 and a second restraining wall 26, these walls, respectively, engaging the near and the upper walls of the hemostat as shown in FIG. I. As is readily apparent from FIGS. 1 and 3, the restraining wall 26 engages the handle portion I6 of the hemostat I2 through the means of a resilient spring member 28. The third flange portion, best shown in FIG. 4, comprises a first restraining wall 30 and a second restraining wall 32, these walls, respectively, engaging the rear and lower walls of the hemostat as shown in FIG. 1. It is thus readily seen that by means of the three flange portions and the spring 28, the bracket 10 can be securely afi'txed to the hemostat I2.

Forming a part of the bracket 10, and, as will be explained .below, aiding in the attachment of the staple magazine pf the present invention, is a wall 34 extending away from the body of the'hemostat I2. As best seen in FIGS. 1, 3 and 5, both

walls

32 and 34 extend from beneath the hemostat 12, with the walls 34 extending over and partially covering the wall 32. Threaded into the wall 34 is a pin 36, the function of which will also be explained below. Forming an integral part of the bracket 10 is a wall 38 which, in combination with

walls

30 and 32, form a chamberlike cavity shown generally at 40. As is readily apparent when reference is made to the FIGS., the bracket 10 can easily slide along the body of the hemostat 12 until the flange 22 encounters a pin 42. And as is also readily apparent, the hemostat I2 is free to operate as if unencumbered by the bracket I0 when said bracket is in its rearward position as shown in FIG. I. Hereinafter, the rearward position, or that shown in FIG. I, will be referred to as the readiness position while the forward position, as is shown in FIG. II, will be referred to as the stapling position. The

reasons for such terminology will become readily apparent when the invention is more fully explained.

With reference now to FIGS. 6 and 7, the construction of the staple magazine is fully explained. The magazine is shown member 46 is adapted to carry a plurality of staples in its thread grooves. Also forming an integral part of the staple magazine is a staple housing 52 into which the staple carrier 46 is positioned, the housing 52 being provided with a slot 54 into which can be seated a ring 56 secured to the staple carrier 46. As seen in FIGS. 6 and 7, the rear end of the staple housing 52, adjacent the slot 54, has a relatively wide opening therein to permit the insertion of the carrier 46 with its associated ring 56. Associated with the staple housing 52, in a manner to be explained below, is a staple driver 58', and positioned at the end of the driver 58 is a staple driving blade 59 having a groove 82 (FIG. 17) extending thereacross. The function of the blade 59 is to eject staples from the housing 52 when the driver is depressed. Also forming a part of the staple magazine is a cam housing 60 in the form of a solid block of material having therein a cylindrical bore 62. Extending through the housing, and fixedly attached thereto, is a pin 64 having an end portion 66 which extends into bore 62. As is explained below, the function of the pin 64, and more particularly its end portion 66, is to engage the groove 50 of the cylindrical cam 48 and to thereby cause rotation of the staple carrier 46. Attached to the cam housing 60 by means of a pin 68 is a wedge-shaped member 70 which, as will be explained below, acts in conjunction with the bracket and the staple driver 58 to eject staples from the staple housing 52.

Referring to FIGS. 8 and 9, it is readily seen that the staple driving blade 59 is secured to the staple driver 58 at an angle A. It is also readily seen that the staple housing 52 is terminated in a similar manner. It should be noted that the housing 52 is designed in such a manner that the staple driving blade 59 slides comfortably through a slot 72 formed at the termination of the housing 52. The reason for terminating the staple driver 58 and the staple housing 52 in the manner described above will become obvious when reference is made to FIGS. 13 through 15.

With reference to FIG. 13, the staple carrier 46 is shown to have a plurality of grooves 74 machined therein, said grooves fonning a thread whose pitch angle is A. Seated in the grooves 74 are a plurality of staples 76. As is best seen in FIG. I4, the staples are biased in such a manner that they resiliently engage the inside walls of the staple housing 52. In this manner, it is obvious that when the shaft of the staple carrier 46 is rotated, the staples 76 advance, in the grooves 74, along the inside wall of the housing 52.

In view of the snug fit between the staples 76 and the housing 52, and in view of the pitch angle of the thread, the

- reason for angling the staple driving blade 59 and the slot 72 should be readily apparent. More particularly, when a staple 76 is freed from a groove 74 in the staple carrier 46, it snugly rests against the walls of the staple housing 52; but because of the pitch angle associated with the threads in the carrier 46, the staple rests at an angle A with respect to the axis of the carrier 46. Therefore, to most efficiently eject the staples from the housing 52, the staple driving blade 59 and the slot 72 are both angled as shown in FIGS. 8 and 9. The forwardmost end of the carrier 46 is also cut at an angle so that when the carrier 46 is rotated to the position in which the staple has just been released from its effects, there exists alignment between the forward end of the carrier 46, the blade 59 and the slot 72. When in this position, the front face of the carrier is parallel to the slot 72 and is spaced from the front wall of the housing 52 a uniform distance slightly greater than the diameter of a staple.

With reference now to FIG. 16, there is shown a front view of the stapling mechanism. It is there seen that a portion of the bracket 10 forms an anvil 78 into which are machined a pair of arcuate slots 80 which serve to insure the proper contour of the staple 76 at the completion of the stapling operation. In FIG. 16, the assembly is shown at a point in time after the end of a stapling stroke, the staple 76 being embedded into a blood vessel 84.

With reference now to FIGS. 10 and 11, there follows a description of the operation of the present invention. In FIG. 11 it is readily seen that the pin 36, which is rigidly secured to the bracket 10, serves both as the pivot point for the staple driver 58 and as the means for fixedly attaching the staple housing 52 to the bracket 10. In FIG. 10, the staple cartridge is shown to be in its readiness position, the bracket 10 slid away from the jaws 18 of the hemostat 12. Further, the cam housing 60 is in its extreme rearward position, the end portion 66 of the pin 64 engaging the extreme rear position of the groove 50, and the staple ejecting wedge 70, when the instrument is in the position shown in this FIG., resting on the pin 36. In this position, the hemostat can be operated as if totally unencumbered by the bracket 10 and its associated staple magazine. The hemostat I2 is here shown to be securely clamping the end of a blood vessel 84.

Once a blood vessel is sealed by means of the hemostat 12, the bracket I0 is slid forward on the hemostat until the flange 22 encounters the pin 42. At that time, the cam housing 60 is manually slid toward the jaws 18 of the hemostat to accomplish the stapling of the vessel 84. When positioned as shown in FIG. 10, the staple next ready to be ejected from the staple housing 52 is remote from its ejection position an amount corresponding to one complete revolution of the staple carrier 46. It therefore becomes readily apparent that for proper operation of the assembly, the groove 50 in the cylindrical cam 48 must be such that one complete revolution of the staple carrier 46 results each time the cam housing 60 is stroked in a forward direction. It is also readily apparent that for proper operation of the staple cartridge, the staple-ejecting wedge 70 must not operate the driver 58 until a staple has reached its proper ejection position. This is accomplished by positioning the wedge 70 so that it engages the wall 38 only after a staple is in position for ejection.

Referring now to FIG. 12, the functions of the cam 48 and its groove 50 are best explained. As pictured in FIG. 12, the pin end 66 engages the groove 50 in a manner similar to that shown in FIG. 10. When the cam housing 60 is moved in the forward direction, the pin slides in the groove 50 in a manner which causes rotation of the staple carrier 46. After one completed revolution of the carrier 46, that amount necessary to advance a staple into a position ready for ejection, the cam cylinder 60 continues to move forward without rotating the carrier 46. The interval during which the staple carrier 46 rotates is termed the indexing period; and the period during which the cam cylinder 60 slides forward without a corresponding rotation in the carrier 46 is termed the stapledriving period. As is best seen in FIG. 10, the staple-driving period is that period between the initial engagement of the staple-ejecting wedge 70 with the wall 38 of the bracket 10 and the completion of the stroke of the staple driving blade 59.

In FIG. 11, the assembly is shown at the end of a staple driving interval. At this time, the cam housing 60 is at its forwardmost position and the staple 76 is securely fastened to the blood vessel 84. At this time, the surgeon strokes the cam housing 60 in the rearward direction and then slides the bracket 10 back from the jaws 18 of the hemostat thus returning the apparatus to that position shown in FIG. 10. As is evident when viewing FIG. 12, the return stroke of the cam housing 60 leaves undisturbed the staple carrier 46 and its associated staples. Once the forward stroke and the rearward stroke of the cam housing 60 are completed, the hemostat can be removed from the blood vessel 84 since a staple 76 securely closes the end of said vessel. The surgeon is then free to clamp the jaws of the hemostat on another blood vessel and repeat the indexing, staple driving and return operations.

' makes possible the clamping of a blood vessel by means of a hemostat, the rapid sealing of said vessel by means of a staple,

and the quick removal of the hemostat in readiness for another stapling operation.

Furthermore, the staple cartridge of the present invention is inexpensive to manufacture and is easily secured to a hemostat. Therefore, such a cartridge can be loaded with staples during manufacture and can be packaged in a surgically sterile container. In this manner, the surgeon can open the cartridge container in the operating room, can secure said cartridge to a hemostat, can dispose of said cartridge upon the exhaustion of its staples, and can quickly introduce to the hemostat another presterilized staple cartridge. As noted in the preceding paragraph, the inventive "hemostat makes it possible for the surgeon, in the operating room, to perform a series of stapling operations and, when the staple cartridge is exhausted, to easily replace the exhausted cartridge with a fresh cartridge. In this regard, two alternative replacement techniques present themselves. The first technique, the more costly of the two, envisions that the cartridge complete with its bracket, be replaced upon exhaustion if its staples. The second technique, while more economical on a cost basis, results in some loss of time in the operating room, contemplating that only the exhausted cartridge be replaced, the bracket remaining mounted on the hemostat.

If the first technique is employed, the surgeon, upon exhaustion of his cartridge, opens the jaws of the hemostat l2, and slides the bracket it) forward until the flange 22 abuts the pin 42. Then the bracket is moved against the bias of the spring 28 until the flange extends over the pin. Then the bracket is further slid forward until the jaws of the hemostat become disengaged from the cavity 40. Then, the flange 22 is easily disengaged from the hemostat 12. A fresh cartridge, with its associated bracket, is inserted on the hemostat 12 by first opening the hemostat, by engaging the flange 22 on the handle portion 16, by then closing the jaws of the hemostat,

and finally by sliding the bracket in a rearward direction until the cavity 40 encircles the jaws of the hemostat.

' Y which is preferably threaded into the wall 34 and removes the entire cartridge assembly 44 from the bracket 10. Then, upon opening a fresh cartridge, the surgeon slides the same into the cavity 40 and, when the pivot of the staple driver 58 is in'alignment with the threaded opening in the wall 34, the pin 36 is replaced, thereby securing the cartridge 44 in the housing 10.

There has been illustrated and described what is considered to be the preferred embodiment of the invention. It will be understood, however, that various modifications may be made without departing from the broader scope of the invention as described by the following claims.

I claim:

l. A staple attachment adapted for mounting on a clamping tool of the type having a pair of gripping jaws and comprising:

staple-carrying means in the form of a threaded screw wherein the thread of said screw is adapted to carry a plurality of staples;

cylindrical cam means fixedly attached to said staplecarrying means;

a staple housing surrounding said staple-carrying means and serving to provide a guide in which said staple-carrying means can rotate;

a staple driver pivotally attached to said staple housing and capable of forcing out of said staple housing a staple which is positioned for ejection;

a cam housing in the form of a solid block of material having therein a cylindrical bore adapted to receive said cylindrical cam, said cam housing serving to provide a guide in which said cylindrical cam can simultaneously rotate about its axis and slide in the direction of its axis; cam pin means associated with said cylindrical cam means and said cam housing for rotating said cylindrical cam means in response to the axial sliding of said cylindrical cam means; staple ejecting means pivotally attached to said cam housing for causing said staple driver to rotate about its pivot point; and

a bracket adapted to be slideably attached to said clamping tool for supporting said staple housing and said staple driver.

2. The invention as set forth in claim 1 wherein a portion of said bracket forms an anvil adapted to receive staples ejected from said staple housing.

3. The invention as recited in claim 2 wherein said staple driver is pivotally attached to said staple housing by a pin and wherein said pin is attached to said bracket securing said driver and said housing to said bracket.

4. The invention as recited in claim 3 wherein said cam pin means is fixedly attached to said cam housing and extends into the bore thereof and wherein said cylindrical cam has set thereinto a series of grooves positively engaged by said cam prn.

5. The invention as recited in claim 4 wherein said cam housing and its associated staple-ejecting means are mounted on said bracket for stroking in a forward and rearward direction and wherein said stroking causes said cam housing and said staple-ejecting means to move relative to said staple housing, said staple driver and said bracket.

6. The invention as recited in claim 5 wherein said stapleejecting means is a wedge which slides against an inside wall of said bracket and which forces said staple driver to rotate about its axis only after said single staple is in a position ready for ejection, said wedge causing rotation in said staple driver as a result of the forward stroke of said cam housing.

' 7. The invention as recited in claim 6 wherein said bracket has two basic positions with respect to said clamping tool, the

first being one of readiness wherein said clamping tool can function normally and the second being adapted for stapling wherein the clamping tool is in engagement with the object to be stapled, said first position being rearward of the gripping jaws of said tool and said second position being one of engagement with said gripping jaws.

8. The invention as recited in claim 7 wherein said bracket has a first flange portion for engaging one of the handles of said hemostat, a second flange portion for engaging two walls of said hemostat near its gripping jaws and a third flange portion, intermediate said first and said second flange portions, for engaging an additional two walls of said hemostat.

9. The invention as set forth in claim 8 and further comprising resilient means associated with said bracket for insuring a secure fit between said bracket and said clamping tool at the handle portion thereof.

10. The invention as recited in claim 5 wherein the pitch of the thread of said staple-carrying means is such that a single staple is advanced into a position ready for ejection each time said cam housing undergoes a forward stroke.

11. The invention are recited in claim 6 wherein said staple housing is of a length substantially equal to that of said staplecarrying means.

12. The invention as recited in claim 11 wherein said staple hammer is of a length substantially equal to that of said staple housing.

13. An attachment adapted for mounting on a clamping tool I such as an hemostat which provides said clamping tool with the additional capability of stapling closed the end of the object being clamped, and comprising:

stapling means for closing the end of said object being clamped by said clamping tool, said stapling means comprising screw means for carrying a plurality of staples, means for rotating said screw means thereby advancing said staples, and means for singly ejecting said stapling means and said mounting means form an integral unit. staples; and 15. The attachment as set forth in claim 14 wherein said means for detachably mounting said stapling m n on m mounting means is such that said attachment is slidably body f said clamping tooL mounted on the body of said clamping tool.

14. The invention as recited in claim 13 wherein said

Claims

1. A staple attachment adapted for mounting on a clamping tool of the type having a pair of gripping jaws and comprising: staple-carrying means in the form of a threaded screw wherein the thread of said screw is adapted to carry a plurality of staples; cylindrical cam means fixedly attached to said staple-carrying means; a staple housing surrounding said staple-carrying means and serving to provide a guide in which said staple-carrying means can rotate; a staple driver pivotally attached to said staple housing and capable of forcing out of said staple housing a staple which is positioned for ejection; a cam housing in the form of a solid block of material having therein a cylindrical bore adapted to receive said cylindrical cam, said cam housing serving to provide a guide in which said cylindrical cam can simultaneously rotate about its axis and slide in the direction of its axis; cam pin means associated with said cylindrical cam means and said cam housing for rotating said cylindrical cam means in response to the axial sliding of said cylindrical cam means; staple ejecting means pivotally attached to said cam housing for causing said staple driver to rotate about its pivot point; and a bracket adapted to be slideably attached to said clamping tool for supporting said staple housing and said staple driver.

4. The invention as recited in claim 3 wherein said cam pin means is fixedly attached to said cam housing and extends into the bore thereof and wherein said cylindrical cam has set thereinto a series of grooves positively engaged by said cam pin.

6. The invention as recited in claim 5 wherein said staple-ejecting means is a wedge which slides against an inside wall of said bracket and which forces said staple driver to rotate about its axis only after said single staple is in a position ready for ejection, said wedge causing rotation in said staple driver as a result of the forward stroke of said cam housing.

7. The invention as recited in claim 6 wherein said bracket has two basic positions with respect to said clamping tool, the first being one of readiness wherein said clamping tool can function normally and the second being adapted for stapling wherein the clamping tool is in engagement with the object to be stapled, said first position being rearward of the gripping jaws of said tool and said second position being one of engagement with said gripping jaws.

11. The invention are recited in claim 6 wherein said staple housing is of a length substantially equal to that of said staple-carrying means.

13. An attachment adapted for mounting on a clamping tool such as an hemostat which provides said clamping tool with the additional capability of stapling closed the end of the object being clamped, and comprising: stapling means for closing the end of said object being clamped by said clamping tool, said stapling means comprising screw means for carrying a plurality of staples, means for rotating said screw means thereby advancing said staples, and means for singly ejecting said staples; and means for detachably mounting said stapling means on the body of said clamping tool.

14. The invention as recited in claim 13 wherein said stapling means and said mounting means form an integral unit.

15. The attachment as set forth in claim 14 wherein said mounting means is such that said attachment is slidably mounted on the body of said clamping tool.